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Khatreja K, Santhiya D. Physicochemical characterization of novel okra mucilage/hyaluronic acid-based oral disintegrating films for functional food applications. Int J Biol Macromol 2024; 278:134633. [PMID: 39128761 DOI: 10.1016/j.ijbiomac.2024.134633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/25/2024] [Accepted: 08/08/2024] [Indexed: 08/13/2024]
Abstract
Oral disintegrating films (ODFs) offer a patient-friendly approach with enhanced convenience and rapid onset of action over various health benefits. ODFs are fabricated for geriatric, pediatric, and individuals facing swallowing challenges. The present work aims to fabricate and characterize ODFs mainly composed of okra mucilage (OM), hyaluronic acid (HA), vitamin-C-loaded bioactive glass nanoparticles (VBG NPs), and clove essential oil. A bio-inspired method was employed to synthesize VBG NPs using fructose template. The nutrient analysis of OM depicted that it is a rich source of protein, carbohydrates, magnesium, and flavonoids (quercetin), accounting for its antioxidant activity. The physicochemical characteristics of the ODFs studied using contact angle measurement, surface pH, opacity, and in vitro disintegration time revealed that ODFs disintegrated rapidly in simulated saliva. The neutral surface pH of ODFs indicates their non-irritant behaviour to the oral mucosa. VBG NPs and essential oil (EO) addition enhance the thermal and mechanical properties. Further, EO infusion in the film matrix resulted in the porous and antibacterial nature of the functional film as revealed by FE-SEM micrographs and antibacterial disk diffusion assay respectively. The obtained novel nutrient-rich ODF is hemocompatible with a hemolysis rate (HR%) <5 % and suitable for functional food applications.
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Affiliation(s)
- Krizma Khatreja
- Department of Applied Chemistry, Delhi Technological University, Bawana Road, Delhi 110 042, India
| | - Deenan Santhiya
- Department of Applied Chemistry, Delhi Technological University, Bawana Road, Delhi 110 042, India.
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Lavaee F, Parhizkar E, Tavakoli F, Zarshenas MM, Asmarian N. Evaluation of the Effects of Punica granatum Flower Tablets on Pain and Healing of Minor Recurrent Aphthous Stomatitis: A Randomized Clinical Trial. Clin Exp Dent Res 2024; 10:e920. [PMID: 39016077 PMCID: PMC11252825 DOI: 10.1002/cre2.920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 05/20/2024] [Accepted: 06/06/2024] [Indexed: 07/18/2024] Open
Abstract
OBJECTIVES The purpose of this study was to determine the therapeutic effect of the Punica granatum (PG) flower on recurrent aphthous stomatitis in comparison with corticosteroid therapy. MATERIALS AND METHODS This cross-over randomized clinical trial was conducted on the patients who had been referred to Shiraz Dental School for their RAS in 2021. All the participants used both P. granatum flower tablets and Triadent a month apart for wash-out time and all compared themselves. In the experimental group, 30 patients received pomegranate flower tablets, three tablets daily, for 6 days. In the control group, oral paste Triadent has been prescribed three times a day for 6 days. The visual analog scale (VAS) and the size of RAS were evaluated on Days 0-6. Data were analyzed by SPSS version 21. The Wilcoxon test was used. RESULTS The mean age of participants was 27.8 ± 14.77 years old. In this study, 15 patients (50%) were men and 15 patients (50%) were women. The mean value of VAS after using prescribed treatment in both evaluated groups on all days was significantly different such that the VAS values were lower for PG flower tablets than Triadent (p value < 0.05). The size of oral lesions in participants who used PG flower tablets was significantly less than those who used Triadent on all evaluation days (p value < 0.05) except on Day 1 (p value = 0.29). The descending slope of VAS from Days 1 to 6 for both Triadent and PG flower tablet users was significant and noticeable. (p value < 0.05). CONCLUSION According to the result of this study, both P. granatum flower tablet and Triadent are useful in reducing the size, period of healing, and VAS of patients with RAS, but the PG flower tablet is more effective.
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Affiliation(s)
- Fatemeh Lavaee
- Oral and Maxillofacial Disease Department, School of DentistryShiraz University of Medical SciencesShirazIran
| | - Elahehnaz Parhizkar
- Department of Pharmaceutics, School of PharmacyShiraz University of Medical SciencesShirazIran
| | - Fatemeh Tavakoli
- Oral and Maxillofacial Medicine Department, School of DentistryShiraz University of Medical SciencesShirazIran
| | - Mohammad M. Zarshenas
- Department of Phytopharmaceuticals (Traditional Pharmacy), School of PharmacyShiraz University of Medical SciencesShirazIran
| | - Naeimehossadat Asmarian
- Anesthesiology and Critical Care Research CenterShiraz University of Medical SciencesShirazIran
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Hanna R, Miron IC, Benedicenti S. A Novel Therapeutic Approach of 980 nm Photobiomodulation Delivered with Flattop Beam Profile in Management of Recurrent Aphthous Stomatitis in Paediatrics and Adolescents-A Case Series with 3-Month Follow-Up. J Clin Med 2024; 13:2007. [PMID: 38610772 PMCID: PMC11012924 DOI: 10.3390/jcm13072007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024] Open
Abstract
Background/Objectives: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal lesions and a very debilitating lesion, especially in paediatric and adolescent patients. The current pharmacotherapy offers a pain relief but not without side effects, and therefore photobiomodulation (PBM) can be an alternative therapy. To the authors' best knowledge, no published study has explored the efficacy of λ 980 nm laser PBM in the management of all RAS subtypes in paediatric and adolescent patients, and therefore, this prospective observational clinical study was conducted to bridge this gap by evaluating λ 980 nm laser PBM efficacy in symptomatic RAS management in paediatric and adolescent patients. The objectives were to evaluate (1) pain intensity alleviation; (2) wound healing rate; (3) wound size closure; (4) a complete resolution; (5) evidence of recurrence; and (6) patients' treatment satisfaction. Methods: The study's variables were assessed at the following timepoints: T0: pre-treatment; T1: immediately after first PBM session; T2: 5 hours (h) post first PBM session (via telephone call); T3: immediately after second PBM session (three days post first PBM session); T4: three-day follow-up (after complete PBM treatments); T5: two-week follow-up; and T6: three-month follow-up. The following PBM dosimetry and treatment protocols were employed: λ 980 nm; 300 mW; 60 s; 18 J; CW; flattop beam profile of 1 cm2 spot size; 18 J/cm2; and twice-a-week irradiation (72 h interval). Results: At T1, significant immediate pain intensity relief was reported. 33.33% recorded "4" and 66.67% reported "5" on the quantitative numeric pain intensity scale (NPIS), and this continued to improve significantly (83.33%) at T2. All the subjects reported "0" on the NPIS at T3, T4, T5 and T6. There was a significant reduction in the lesion surface area (>50% complete healing) at T3 compared to T0. Complete healing (100%) with no evidence of scarring and lesion recurrence observed at T4, T5 and T6. Very good patients' satisfaction was reported at all timepoints. Conclusions: This is the first report demonstrating λ980 nm efficacy in all RAS subtype management in paediatric and adolescent patients with a 3-month follow-up, whereby its PBM dosimetry and treatment protocols were effective from scientific and practical standpoints, and hence multicentre RCTs with large data are warranted to validate its reproducibility and to enrich the knowledge of PBM application in all RAS subtypes.
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Affiliation(s)
- Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (I.C.M.); (S.B.)
- Department of Restorative Dental Sciences, UCL-Eastman Dental Institute, Medical School, University College London, London WC1E 6DE, UK
- Department of Oral Surgery, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
| | - Ioana Cristina Miron
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (I.C.M.); (S.B.)
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (I.C.M.); (S.B.)
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Barbosa LM, Oliveira LMLD, Queiroz CPV, Freitas BAS, Lima TMPD, Aguiar JLDA, Medeiros Júnior MD, Perez DEDC, Godoy GP. The effect of biopolymer gel derived from sugarcane on healing of traumatic oral ulcers: an experimental study. Acta Cir Bras 2024; 39:e390724. [PMID: 38477784 DOI: 10.1590/acb390724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/28/2023] [Indexed: 03/14/2024] Open
Abstract
PURPOSE The extracellular polysaccharide (EPS) is produced by the bacterium Zoogloea sp. and plays a positive role in tissue repair. The purpose of this study was to clinically and histologically compare the effects of EPS in the healing of traumatic oral ulcers in rats with the effects of triamcinolone. METHODS Ulcers were induced in the oral mucous of 45 male Wistar rats, divided into three groups: control group, treated with triamcinolone, and treated with biopolymer gel. In the clinical evaluation, we considered the weight variation of the animals and the size of the lesion area, at baseline and on treatment days 1, 3 and 7. The histological parameters evaluated were the type and intensity of the inflammatory infiltration, the presence of necrosis and foreign body granuloma and the degree of re-epithelialization of the lesion. RESULTS The reduction of the lesion area was greater in the animals treated with EPS, with no difference in the intensity of the inflammatory infiltration between the groups on days 3 and 7 of treatment. CONCLUSIONS The results suggest that topical application of EPS in traumatic oral ulcers of rats promotes faster repair than triamcinolone ointment, without increasing the intensity of inflammatory infiltration under the lesion.
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Zhang K, Chen H, Hao Y, Li W, Li Y, Zhang W, Chen Y. Armillariella tabescens polysaccharide treated rats with oral ulcers through modulation of oral microbiota and activation of the Nrf2/HO-1 pathway. Int J Biol Macromol 2024; 261:129697. [PMID: 38272409 DOI: 10.1016/j.ijbiomac.2024.129697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/04/2024] [Accepted: 01/21/2024] [Indexed: 01/27/2024]
Abstract
We identified Armillariella tabescens polysaccharide (PAT-W), a compound isolated from a Chinese medicinal mushroom, as a potential novel oral ulcer (OU) drug. In treating OU rats with PAT-W, especially in the high-dose group, oral mucous tissue TNF-α, IL-1β, and IL-6 levels were markedly reduced, and pathological morphology and oxidative stress were effectively improved. Western blot analysis showed that the PAT-W channel ameliorated OU mucous tissue damage, which depends on the activation of the Nrf2/HO-1 antioxidant signaling pathway. Furthermore, high-throughput sequencing results showed that PAT-W regulated the maladjustment of the oral microbiota caused by OU. Therefore, based on the new viewpoint of activating the Nrf2/HO-1 pathway and regulating oral microbiota, PAT-W is expected to become a new natural drug for treating oral ulcers and improving patients' quality of life.
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Affiliation(s)
- Kunfeng Zhang
- Anhui Key Laboratory of Ecological Engineering and Biotechnology, School of Life Sciences, Anhui University, Hefei 230601, Anhui, China; Jiangsu Key Laboratory of Bioactive Natural Product Research and State Key Laboratory of Natural Medicines, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, People's Republic of China
| | - Hao Chen
- Anhui Key Laboratory of Ecological Engineering and Biotechnology, School of Life Sciences, Anhui University, Hefei 230601, Anhui, China
| | - Yunbo Hao
- Anhui Key Laboratory of Ecological Engineering and Biotechnology, School of Life Sciences, Anhui University, Hefei 230601, Anhui, China
| | - Wensen Li
- Jiangsu Key Laboratory of Bioactive Natural Product Research and State Key Laboratory of Natural Medicines, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, People's Republic of China
| | - Yong Li
- Anhui Key Laboratory of Ecological Engineering and Biotechnology, School of Life Sciences, Anhui University, Hefei 230601, Anhui, China
| | - Wenna Zhang
- Anhui Key Laboratory of Ecological Engineering and Biotechnology, School of Life Sciences, Anhui University, Hefei 230601, Anhui, China
| | - Yan Chen
- Anhui Key Laboratory of Ecological Engineering and Biotechnology, School of Life Sciences, Anhui University, Hefei 230601, Anhui, China.
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Alrashdan MS, Andreadis D, Zisis V, Hassona Y. Immune-mediated oral mucosal pathology: a comprehensive review and update for clinicians - part II. Ital J Dermatol Venerol 2024; 159:11-22. [PMID: 38345290 DOI: 10.23736/s2784-8671.23.07690-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
The oral mucosa can be involved in a wide variety of mucocutaneous conditions that may present primarily in the mouth or affect other cutaneous or mucosal sites. Many of these conditions are immune mediated and typically present as inflammatory mucosal pathology. Patients experiencing such conditions usually seek medical evaluation and treatment due to the associated pain and discomfort, and occasionally taste disturbance or dysphagia and the overall deterioration in the oral health-related quality of life. These conditions share some common features and there could be some overlap in their clinical presentation, which can lead to delays in diagnosis and proper management of patients. Clinicians dealing with such disorders, including dermatologists, need to be aware of the oral manifestations of mucocutaneous conditions, their clinical features, underlying mechanisms, diagnostic approaches, and treatment options, as well as the recent advances in the research on these conditions. This review provides a comprehensive, evidence-based reference for clinicians, with updated insights into a group of immune mediated conditions known to cause oral mucosal pathology. Part one will cover oral lichen planus, erythema multiforme and systemic lupus erythematosus, while part two will cover recurrent aphthous stomatitis, pemphigus vulgaris and mucous membrane pemphigoid, in addition to the less common disorders linear IgA disease, dermatitis herpetiformis and epidermolysis bullosa.
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Affiliation(s)
- Mohammad S Alrashdan
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates -
- Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan -
| | - Dimitrios Andreadis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Zisis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Yazan Hassona
- Faculty of Dentistry, Al-Ahliyya Amman University, Amman, Jordan
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Dong Y, Lou F, Yan L, Luo S, Zhang Y, Liu Y, Lv S, Xu J, Kang N, Luo Z, Liu Y, Pu J, Ji P, Jin X. Salivary microbiota and metabolic phenotype of patients with recurrent aphthous ulcers. Oral Dis 2024. [PMID: 38169073 DOI: 10.1111/odi.14852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/03/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES Recurrent aphthous ulcer (RAU) is a prevalent oral mucosal disease, affecting around 20% of the global population. It can greatly impair the quality of life for affected individuals. However, the exact etiology of RAU remains unknown. SUBJECTS AND METHODS 16S rRNA sequencing (16S rRNA-seq) and non-targeted liquid chromatography-mass spectrometry (LC-MS) were employed to investigate the salivary microbiota and metabolic phenotype between RAU patients (N = 61) and healthy controls (HCs) (N = 105). RESULTS Findings from 16S rRNA -seq indicated reduced oral microbial diversity in RAU patients compared to HCs, but increased interactions. Clinical variables did not show any significant association with the overall diversity of oral microbiota in RAU patients. However, significant correlations were observed between specific microorganisms and clinical variables. LC-MS results revealed dysregulation of amino acid, lipid, nucleotide, and caffeine metabolism in RAU patients. Furthermore, correlation analysis of 16S rRNA-seq and LC-MS data revealed a significant association between salivary microbiota and metabolites in RAU patients. CONCLUSIONS Our study revealed notable differences in salivary microbiota and metabolic profiles between RAU patients and HCs, indicating a strong link between oral microbiota dysbiosis, metabolic disturbances, and the onset and progression of RAU.
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Affiliation(s)
- Yunmei Dong
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Fangzhi Lou
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Li Yan
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Shihong Luo
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yingying Zhang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yang Liu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Shiping Lv
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Jingyi Xu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Ning Kang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Zhuoyan Luo
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Yiyun Liu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juncai Pu
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ping Ji
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Xin Jin
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, College of Stomatology, Chongqing Medical University, Chongqing, China
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Simsek A, Ozmen O. Histopathological and Immunohistochemical Effects of Tarantula cubensis Extract on Mucosal Healing in Rats. J Vet Dent 2024; 41:17-25. [PMID: 37157804 DOI: 10.1177/08987564231172907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Oral mucosal lesions are a common pathology that impact the quality of life due to pain, inappetence, weight loss, and low productivity. The purpose of this study is to evaluate the effects of Tarantula cubensis extract on wound healing in rats with buccal mucosal lesions. A total of 40 male Wistar albino rats weighing 250-300 g were used in the study. The rats were divided into four equal groups. A 3 mm diameter mucosal defect was created in the buccal mucosa of each rat. Groups one and three (controls) assessed spontaneous healing at 3 and 6 days post trauma, respectively. Groups two and four (treatment) received 0.2 ml T. cubensis extract subcutaneously. Group two was treated for 2 days and assessed at 3 days and group four was treated for 5 days and assessed at 6 days. All rats were euthanatized prior to tissue sample collection. Tissue samples were compared between control and treatment groups using histopathology and immunohistochemistry. Tissue samples taken from the defect areas were immunohistochemically evaluated for cytokeratin and collagen expressions. In both the 3 and 6 day treatment groups, the improvements were statistically different compared to the control groups. T. cubensis extract was found to increase cytokeratin and collagen in both epithelial and connective tissue and to have a significant healing effect on mucosa on both gross and microscopic findings.
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Affiliation(s)
- Ali Simsek
- Department of Pathology, Faculty of Veterinary Medicine, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Ozlem Ozmen
- Department of Pathology, Faculty of Veterinary Medicine, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
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A O Lewis M, Lamey PJ. Oral ulceration (Part 2). Br Dent J 2023; 235:940-945. [PMID: 38102261 DOI: 10.1038/s41415-023-6549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Ulceration is probably the oral mucosal condition seen most frequently by general dental practitioners. It is almost always painful and therefore sufferers are prompt to seek advice. An important exception to this generalisation is the occurrence of oral squamous cell carcinoma, which is often painless in its early stages. Definitive diagnosis, which requires mucosal biopsy, is mandatory for any persistent area of oral ulceration.
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Affiliation(s)
- Michael A O Lewis
- School of Dentistry, Cardiff University School of Dentistry, Cardiff, United Kingdom.
| | - Philip-John Lamey
- Edinburgh Dental Institute, University of Edinburgh, Edinburgh, Dental Institute, Edinburgh, United Kingdom
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Oluwadaisi AM, Aborisade AO, Oyetola EO, Owotade FJ, Agho ET. Hematological parameters, obesity, stress and oxidant - antioxidant indicators in patients with or without recurrent aphthous stomatitis: A case control study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101654. [PMID: 37838166 DOI: 10.1016/j.jormas.2023.101654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/10/2023] [Indexed: 10/16/2023]
Abstract
INTRODUCTION Recurrent Aphthous Stomatitis (RAS) is a frequent chronic disease of the oral cavity that affects 5-25 % of the population with a plethora of predisposing factors. Despite its equivocal etiology, immune alterations, hematologic deficiencies and oxidative stress has been reported to be significant etiologic factors. Stress and obesity are other environmental factors that have been studied to understand associations with RAS. OBJECTIVES This study investigated the association of stress, hematologic parameters, oxidative indices and other selected salivary factors in a case control study on RAS Methods: Twenty-two participants each in both case and control groups were recruited with saliva and serum samples collected from them after a self-administered Recent Life Changing Questionnaire (RLCQ). OHI-S and salivary flow rate (SFR) were calculated with selected hematologic parameters and oxidative indices such as Total oxidant (TOS) and anti-oxidant (TAS) levels and their ratio - Oxidative Stress Index (OSI). Anti-oxidative indices of Ferric-Reducing Antioxidant Power (FRAP) and Glutathione Peroxidase Activity (GsPHx) were also estimated. RESULTS The RAS group had a significantly higher RLCQ scores at a median of 145 more than the control (57.5). There was no significant in their obesity indices, however there was a significant higher mean in the ESR (p< 0.0001) and Vit B12 (p = 0.0001); OHI-S was also significantly higher in the RAS group with a median of 1.65. Both the salivary and serum TOS were significantly higher in the RAS (10.0 ± 3.8, 15.4 ± 8.9) compared to the control group (7.92 ± 1.49, 9.56 ± 3.5). GsPHx activity was significantly higher in both the saliva and serum in the control group (0.08 ± 0.08, 0.19 ± 0.11) while nil significant difference was found in the FRAP activity. Regression showed most important variables to be the salivary GsPHx activity, followed by serum OSI and GsPHx activity. CONCLUSION The oxidative indices of TOS, TAS and GsPHx can serve as significant biomarkers in detecting RAS. This further corroborates the role of immune dysregulation in the etiology and predisposition to RAS.
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Affiliation(s)
- Adeniyi M Oluwadaisi
- Department of Oral Pathology and Medicine, Obafemi Awolowo University Teaching Hospital Complexes, Ile- Ife, Osun State, Nigeria
| | - Adetayo O Aborisade
- Department of Oral Diagnostic Sciences, Aminu Kano Teaching Hospital/ Bayero University, Kano, Kano, Nigeria.
| | - Elijah O Oyetola
- Department of Oral Pathology and Medicine, Obafemi Awolowo University Teaching Hospital Complexes, Ile- Ife, Osun State, Nigeria
| | - Foluso J Owotade
- Department of Oral Pathology and Medicine, Obafemi Awolowo University Teaching Hospital Complexes, Ile- Ife, Osun State, Nigeria
| | - Ekhosuehi T Agho
- Department of Dental and Maxillofacial Surgery, National Hospital, Abuja, Nigeria
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11
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Lewis MAO, Lamey PJ. Oral ulceration (Part 1). Br Dent J 2023; 235:869-874. [PMID: 38066141 DOI: 10.1038/s41415-023-6504-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Ulceration is probably the oral mucosal condition seen most frequently by general dental practitioners. It is almost always painful and therefore sufferers are prompt to seek advice. An important exception to this generalisation is the occurrence of oral squamous cell carcinoma, which is often painless in its early stages. Definitive diagnosis, which requires mucosal biopsy, is mandatory for any persistent area of oral ulceration.
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Affiliation(s)
- Michael A O Lewis
- School of Dentistry, Cardiff University School of Dentistry, Cardiff, United Kingdom.
| | - Philip-John Lamey
- Edinburgh Dental Institute, University of Edinburgh, Edinburgh, United Kingdom
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12
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Reddy SM, Kumar Vadivel J, Ramalingam K. Prevalence of Aphthous Stomatitis: A Cross-Sectional Epidemiological Study. Cureus 2023; 15:e49288. [PMID: 38143711 PMCID: PMC10748215 DOI: 10.7759/cureus.49288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Recurrent aphthous stomatitis (RAS) is a common ulcer of idiopathic etiology but is recurrent, causing painful ulcers in the non-keratinized mucosa. The disease is commonly seen in people aged 10-40 years. The etiology of RAS has yet to be well established, but several risk factors that lead to the development of RAS have been proven in the literature. With an unknown etiology, developing a definitive cure and maintaining disease remission remains challenging. An epidemiological survey will shed some light on the disease's prevalence, which could provide insights into disease management. This study aimed to study the prevalence of aphthous stomatitis among the patients visiting the dental outpatient services of a dental college in South India. The objectives were to discover the different subtypes of aphthous stomatitis and the age predominance of the type of ulcer. Materials and methods The data was collected from the case records of Saveetha Dental College and Hospitals, Chennai, India, dated from June 2019 to June 2023. The age and gender of the patients with RAS were recorded. The details collected were systematically arranged in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States) and further analyzed using IBM SPSS Statistics for Windows, Version 24.0 (Released 2016; IBM Corp., Armonk, New York, United States) and chi-square tests were run to check for statistical significance. Results A total of 1,44,056 patients visited the Dental OPD during the study period. Of these, 1115 patients had RAS. When the data was analyzed, there was a three-fold increase in the occurrence of RAS during the coronavirus disease 2019 (COVID-19) pandemic, which was statistically significant (p=0.043). The most commonly affected age group was 26-40 years. Among the clinical variants of RAS, it was found that 82.5% of RAS patients had a minor variant of aphthous stomatitis. Conclusion This study shows the prevalence of different types of aphthous stomatitis, wherein we noticed that the minor clinical variant was the most common, followed by the major variant. The lesions were more commonly seen in women. However, the age group most commonly affected was 26-40 years.
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Affiliation(s)
- Shweta Mary Reddy
- Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Jayanth Kumar Vadivel
- Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Karthikeyan Ramalingam
- Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Conejero Del Mazo R, García Forcén L, Navarro Aguilar ME. [Recurrent aphthous stomatitis]. Med Clin (Barc) 2023; 161:251-259. [PMID: 37357066 DOI: 10.1016/j.medcli.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/27/2023]
Abstract
Recurrent aphthous stomatitis (RAS) is the most common clinical disease of the oral mucosa. Its prevalence in the general population varies between 5 and 25%, with its peak appearance in the second decade of life. So far, the etiopathogenesis is not clear. In genetically predisposed patients, the effect of certain triggering factors would initiate the proinflammatory cytokine cascade directed against certain regions of the oral mucosa. Ulcers are round or oval with well-defined erythematous margins and a shallow ulcerated center covered with a gray or yellowish fibrinous pseudomembrane. The ulcers may reappear at intervals of a few days and months. Given the appearance of periodic thrush in the oral mucosa, the first thing to do is to make a correct differential diagnosis, rule out associated systemic diseases and assess treatable causes before reaching the diagnosis of RAS. At present, there is no curative treatment.
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Affiliation(s)
| | - Laura García Forcén
- Centro de Salud Ejea de los Caballeros, Ejea de los Caballeros, Zaragoza, España
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14
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Assiri K, Hosmani J, Chalikkandy SN, Alkahtani AM, Alhanif RM, Alsarh SA, Patil S, Reda R, Testarelli L. Correlating Salivary Levels of Immunoglobin E and Human Eosinophil Cationic Protein in the Aseer Cohort with Recurrent Apthous Stomatitis. Int J Gen Med 2023; 16:2923-2931. [PMID: 37457753 PMCID: PMC10348369 DOI: 10.2147/ijgm.s410061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
Background Repeated Aphthous Stomatitis (RAS) is the most prevalent inflammatory disorder of the oral mucosa, characterized by recurrent emergence of single or numerous painful ulcers. RAS usually affects healthy people without systemic illnesses. There is evidence linking atopy to the progression of this illness. Immunoglobulin E (IgE) and human eosinophil cationic protein (HECP) levels in the saliva of individuals with aphthous stomatitis were assessed as allergy-related indicators. Materials and Methods Sixty people were assessed for this study. 30 patients with RAS were included in the patient group, while 30 healthy individuals made up for the control group. Sixty participants' non-stimulated saliva was taken and IgE and HECP were evaluated using enzyme-linked immunosorbent assay (ELISA). Data were analyzed in SPSS 20 through the Mann-Whitney test and p<0.05 was considered significant. Results The salivary level of HECP was significantly (p 0.05) higher among cases (0.83 0.70) compared to controls (0.170 0.15), whereas the salivary level of IgE was not significantly (p = 0.41) higher among cases (35.60 11.19) compared to controls (67.42 18.34). Conclusion Even though this study found a positive correlation between elevated HECP levels and RAS, additional research with larger sample sizes is required to identify the biological mechanisms responsible for the observed associations and to include salivary HECP levels in the RAS patient's evaluation.
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Affiliation(s)
- Khalil Assiri
- Department of Diagnostic Dental Sciences, College of Dentistry, King Khalid University, Abha, 62529, Saudi Arabia
| | - Jagadish Hosmani
- Department of Diagnostic Dental Sciences, College of Dentistry, King Khalid University, Abha, 62529, Saudi Arabia
| | | | - Abdullah M Alkahtani
- Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | - Shankargouda Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, 84095, USA
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00161, Italy
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00161, Italy
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15
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Verdelli A, Corrà A, Mariotti EB, Aimo C, Quintarelli L, Ruffo di Calabria V, Donati ME, Bonciolini V, Antiga E, Caproni M. Skin gluten-related disorders: new and old cutaneous manifestations to be considered. Front Med (Lausanne) 2023; 10:1155288. [PMID: 37265490 PMCID: PMC10229844 DOI: 10.3389/fmed.2023.1155288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/28/2023] [Indexed: 06/03/2023] Open
Abstract
The term gluten-related disorders (GRD) refer to a spectrum of different clinical manifestations triggered by the ingestion of gluten in genetically susceptible individuals, including coeliac disease (CD), wheat allergy and non-celiac gluten sensitivity (NCGS). GRD are characterized by a large variety of clinical presentations with both intestinal and extra-intestinal manifestations. The latter may affect almost every organ of the body, including the skin. Besides the well-known association between CD and dermatitis herpetiformis, considered as the cutaneous specific manifestation of CD, many other muco-cutaneous disorders have been associated to GRD. In this review, we analyzed the main features of dermatological diseases with a proven association with GRD and those that improve after a gluten-free diet, focusing on the newly described cutaneous manifestations associated with NCGS. Our main hypothesis is that a "cutaneous-gluten sensitivity," as specific cutaneous manifestation of NCGS, may exist and could represent a diagnostic marker of NCGS.
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Affiliation(s)
- Alice Verdelli
- Department of Health Sciences, Rare Dermatological Diseases Unit, Azienda USL Toscana Centro, European Reference Network-Skin Member, Florence, Italy
| | - Alberto Corrà
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Cristina Aimo
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Lavinia Quintarelli
- Department of Health Sciences, Rare Dermatological Diseases Unit, Azienda USL Toscana Centro, European Reference Network-Skin Member, Florence, Italy
| | | | - Marta Elettra Donati
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Emiliano Antiga
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Marzia Caproni
- Department of Health Sciences, Rare Dermatological Diseases Unit, Azienda USL Toscana Centro, European Reference Network-Skin Member, Florence, Italy
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16
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Cofré-Leiva C, Camargo-Ayala PA, Vergara-Pérez A, Hernández-Olivos R, Sanhueza S, Nova-Lamperti E, Zúñiga-Hernández J, Rivera C. Salivary proteins offer insights into keratinocyte death during aphthous stomatitis. A case-crossover study. BMC Oral Health 2023; 23:279. [PMID: 37170213 PMCID: PMC10176878 DOI: 10.1186/s12903-023-02955-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/09/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND The death of oral keratinocytes is a crucial step in the emergence of recurrent aphthous stomatitis (RAS, also known as aphthae or aphthous ulcers). Since there are no experimental models available to research aphthous ulcers, little is understood about this process. We hypothesize that saliva can be a data bank of information that offers insights on epithelial damage. METHODS In this case-crossover study, we assessed the salivary proteome of patients with RAS (n = 36) in the presence and absence of ulcers using discovery proteomics and bioinformatics. Additionally, we contrasted these patterns with those of healthy individuals (n = 31) who had no prior aphthous ulceration. RESULTS Salivary proteome showed that during the ulcerative phase, controlled cell death was downregulated. Due to its ability to distinguish between individuals with and without ulcers, the ATF6B protein raises the possibility that endoplasmic reticulum (ER) stress is responsible for the damage that leads to the death of oral keratinocytes. The high abundance of TRAP1 and ERN1 matches with this biological discovery. The type of death is immunogenic, according to the functional data found in a cell death database. CONCLUSION We identified a cellular process that can lead to the death of oral keratinocytes in the etiopathogenesis process of RAS. Future studies should be conducted to identify what is responsible for the increase in ER stress signaling that would lead to an anti-cell death response.
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Affiliation(s)
- Camila Cofré-Leiva
- Departamento de Ciencias Básicas Biomédicas, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Paola Andrea Camargo-Ayala
- Departamento de Ciencias Básicas Biomédicas, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - Angela Vergara-Pérez
- Laboratorio de Histopatología Oral y Maxilofacial, Departamento de Estomatología, Facultad de Odontología, Universidad de Talca, Avenida Lircay S/N, Campus Norte Universidad de Talca, Talca, Oficina, N°4, Chile
| | - Romina Hernández-Olivos
- Laboratorio de Histopatología Oral y Maxilofacial, Departamento de Estomatología, Facultad de Odontología, Universidad de Talca, Avenida Lircay S/N, Campus Norte Universidad de Talca, Talca, Oficina, N°4, Chile
| | - Sergio Sanhueza
- Laboratorio de Inmunología Translacional, Departamento de Bioquímica Clínica e Inmunología, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
| | - Estefanía Nova-Lamperti
- Laboratorio de Inmunología Translacional, Departamento de Bioquímica Clínica e Inmunología, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
| | - Jessica Zúñiga-Hernández
- Departamento de Ciencias Básicas Biomédicas, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile
| | - César Rivera
- Laboratorio de Histopatología Oral y Maxilofacial, Departamento de Estomatología, Facultad de Odontología, Universidad de Talca, Avenida Lircay S/N, Campus Norte Universidad de Talca, Talca, Oficina, N°4, Chile.
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17
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Meng Y, Li XJ, Li Y, Zhang TY, Liu D, Wu YQ, Hou FF, Ye L, Wu CJ, Feng XD, Ju XJ, Jiang L. Novel Double-Layer Dissolving Microneedles for Transmucosal Sequential Delivery of Multiple Drugs in the Treatment of Oral Mucosa Diseases. ACS APPLIED MATERIALS & INTERFACES 2023. [PMID: 36892578 DOI: 10.1021/acsami.2c19913] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The development of transmucosal drug delivery systems is a practical requirement in oral clinical practice, and controlled sequential delivery of multiple drugs is usually required. On the basis of the previous successful construction of monolayer microneedles (MNs) for transmucosal drug delivery, we designed transmucosal double-layer sequential dissolving MNs using hyaluronic acid methacryloyl (HAMA), hyaluronic acid (HA), and polyvinyl pyrrolidone (PVP). MNs have the advantages of small size, easy operation, good strength, rapid dissolution, and one-time delivery of two drugs. Morphological test results showed that the HAMA-HA-PVP MNs were small and intact in structure. The mechanical strength and mucosal insertion test results indicated the HAMA-HA-PVP MNs had appropriate strength and could penetrate the mucosal cuticle quickly to achieve transmucosal drug delivery. The in vitro and in vivo experiment results of the double-layer fluorescent dyes simulating drug release revealed that MNs had good solubility and achieved stratified release of the model drugs. The results of the in vivo and in vitro biosafety tests also indicated that the HAMA-HA-PVP MNs were biosafe materials. The therapeutic effect of drug-loaded HAMA-HA-PVP MNs in the rat oral mucosal ulcer model demonstrated that these novel HAMA-HA-PVP MNs quickly penetrated the mucosa, dissolved and effectively released the drug, and achieved sequential drug delivery. Compared to monolayer MNs, these HAMA-HA-PVP MNs can be used as double-layer drug reservoirs for controlled release, effectively releasing the drug in the MN stratification by dissolution in the presence of moisture. The need for secondary or multiple injections can be avoided, thus improving patient compliance. This drug delivery system can serve as an efficient, multipermeable, mucosal, and needle-free alternative for biomedical applications.
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Affiliation(s)
- Yang Meng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xin Jiao Li
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, P.R. China
| | - Yao Li
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, P.R. China
| | - Tian Yu Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Dan Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yu Qi Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Fei Fei Hou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Lu Ye
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Chuan Ji Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xiao Dong Feng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xiao Jie Ju
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, P.R. China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, P.R. China
| | - Lu Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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18
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Cai X, Shi W, Lian J, Zhang G, Cai Y, Zhu L. Characterization of immune landscape and development of a novel N7-methylguanine-related gene signature to aid therapy in recurrent aphthous stomatitis. Inflamm Res 2023; 72:133-148. [PMID: 36352034 DOI: 10.1007/s00011-022-01665-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Recurrent aphthous stomatitis (RAS) is the most common inflammatory disease of the oral mucosa resulting in an impaired life quality and even leading to tumors in susceptible populations. N7-Methylguanine (m7G) plays a vital role in various cellular activities but has not yet been investigated in RAS. We aimed at picturing the immune landscape and constructing an m7G-related gene signature, and investigating candidate drugs and gene-disease association to aid therapy for RAS. METHODS For our study, m7G-related differentially expressed genes (DEGs) were screened. We outlined the immune microenvironment and studied the correlations between the m7G-related DEGs and immune cells/pathways. We performed functional enrichment analyses and constructed the protein-protein interaction (PPI) and multifactor regulatory network in RAS. The m7G-related hub genes were extracted to formulate the corresponding m7G predictive signature. RESULTS We obtained 11 m7G-related DEGs and studied a comprehensive immune infiltration landscape, which indicated several immune markers as possible immunotherapeutic targets. The PPI and multifactor regulatory network was constructed and 4 hub genes (DDX58, IFI27, IFIT5, and PML) were identified, followed by validation of the corresponding m7G predictive signature for RAS. GO and KEGG analyses revealed the participation of JAK-STAT and several immune-related pathways. Finally, we suggested candidate drugs and gene-disease associations for potential RAS medical interventions. CONCLUSIONS The present study pictured a comprehensive immune infiltration landscape and suggested that m7G played a vital role in RAS through immune-related pathways. This study provided new insight for the future investigation of the mechanisms and therapeutic strategies for RAS.
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Affiliation(s)
- Xueyao Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China
| | - Wenjun Shi
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China
| | - Jie Lian
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China
| | - Guoyou Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China
| | - Yuchen Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China.
| | - Lian Zhu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi-Zao-Ju Road, Huangpu District, Shanghai, 200011, China.
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19
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Pan D, Qing MF, Ma DH, Wei J, Wang Z, Cai LY, Xu H, Zhou Y, Chen QM. Detection of the peripheral blood antigens and clinical value in recurrent aphthous ulcer: A cross-section study. J Dent Sci 2023; 18:304-309. [PMID: 36643277 PMCID: PMC9831785 DOI: 10.1016/j.jds.2022.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 05/21/2022] [Indexed: 01/18/2023] Open
Abstract
Abstract Background/purpose Recurrent aphthous ulcer (RAU) is one of the most common diseases of oral mucosa, which is generally believed to be related to immunity, though the etiology is still unclear. It is suspected that allergies are directly related to RAU. So we sought to explore the relationship between hypersensitivity and RAU. Materials and methods 40 RAU patients who were in ulceration period and 40 people who were in good health were selected from Jan 2016 to Feb 2017, matched in age and sex. The peripheral blood antigens of 40 RAU patients and 40 healthy people was tested, and serum specific IgE (sIgE) with 6 groups of antigens and total IgE (tIgE) analysis was performed to identify IgE-mediated allergic reaction possibly affecting RAU. We then investigated the food intolerance and IgG levels to discover the correlation between non-IgE mediated allergic reaction and RAU. Results The positive cases and rate of sIgE in RAU group was higher than that of control, but the difference was not statistically significant (P>0.05). Positive grade of animal fur scraps (EX1), house dust mixed (HX2) and the serum tIgE concentration of the RAU group were significantly higher than the control group (P<0.05).The number of food intolerance in RAU group was significantly higher than that in control group (P<0.05). Conclusion Our findings suggested certain correlation between RAU and anaphylaxis. Daily contact allergens and food intolerance may be one of the causes of RAU. Moreover, this provides reference value for clinical diagnosis and treatment.
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Affiliation(s)
- Dan Pan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Mao-feng Qing
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Dan-hua Ma
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiao Wei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China,Department of Oral Mucosal Diseases, State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Disease and Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military University, Xi'an, Shanxi, China
| | - Zhen Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lu-yao Cai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Hao Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China,Corresponding author. State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Sec 3 Renminnan Road, Chengdu, Sichuan, 610041, China.
| | - Yu Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China,Corresponding author. State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Sec 3 Renminnan Road, Chengdu, Sichuan, 610041, China.
| | - Qian-ming Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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20
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Alginate/Chitosan-Based Hydrogel Film Containing α-Mangostin for Recurrent Aphthous Stomatitis Therapy in Rats. Pharmaceutics 2022; 14:pharmaceutics14081709. [PMID: 36015335 PMCID: PMC9414115 DOI: 10.3390/pharmaceutics14081709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/17/2022] Open
Abstract
Recurrent aphthous stomatitis (RAS) is a prevalent clinical disorder that causes mouth ulcers. Furthermore, corticosteroid treatment has been widely utilized for RAS therapy; however, it has side effects on the oral mucosa that limit its application. This study aimed to develop a novel RAS therapy with the natural ingredient α-mangostin, delivered by alginate and chitosan polymers-based hydrogel film (α-M Alg/Chi-HF). To prepare α-M Alg/Chi-HF, the solvent evaporation and casting methods were used, then characterized by using SEM, FTIR, and XRD. Based on the characterization studies, the α-M in α-M/EtOH Alg/Chi-HF with ethanol (EtOH) was found to be more homogenous compared to α-M in Alg/Chi-HF with distilled water (H2O) as a casting solvent. The in vitro viability study using NIH3T3 cells showed 100% viability of α-M Alg/Chi-HF (EtOH) and Alg/Chi-HF after 24 h incubation, indicating well tolerability of these hydrogel films. Interestingly, the in vivo studies using male white rats (Rattus norvegicus Berkenhout) proved that α-M/EtOH Alg/Chi-HF with a recovery of 81.47 ± 0.09% in seven days significantly more effective RAS therapy compared to control. These results suggest that α-M/EtOH Alg/Chi-HF has the potential as an alternative for RAS therapy.
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21
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Li XJ, Li Y, Meng Y, Pu XQ, Qin JW, Xie R, Wang W, Liu Z, Jiang L, Ju XJ, Chu LY. Composite dissolvable microneedle patch for therapy of oral mucosal diseases. BIOMATERIALS ADVANCES 2022; 139:213001. [PMID: 35882148 DOI: 10.1016/j.bioadv.2022.213001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
A composite microneedle patch (MN patch) is developed for oral transmucosal administration. To improve the oral transmucosal drug delivery efficiency, the composite MN patch is designed to consist of an array of 100 dissolvable microneedles (MNs) with drug-loaded tips and a backing layer. The MNs are composed of two parts, the hyaluronic acid (HA) tip part and the polyvinylpyrrolidone (PVP) base part. Due to the small size and sufficient mechanical strength, the HA-PVP MNs can painlessly penetrate the oral mucosa barrier and deliver drugs directly to the basal layer or submucosa. Betamethasone sodium phosphate (BSP), as the model drug, is concentrated in the HA tip parts to avoid the drug waste caused by mucosa elasticity. Considering the special moist environment and saliva flow in the mouth, a double-layer backing layer composed of a poly(vinyl alcohol) (PVA) adhesive layer and an ethyl cellulose (EC) waterproof layer is designed and constructed, which could reduce the saliva flow effects. The in vitro and in vivo results demonstrate that the MN patch could achieve rapid and efficient BSP release in oral mucosa due to the rapid dissolution of HA. The proposed MN patch provides a novel strategy for the therapy of oral mucosal diseases.
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Affiliation(s)
- Xin-Jiao Li
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Yao Li
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Yang Meng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xing-Qun Pu
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Jia-Wang Qin
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Rui Xie
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Wei Wang
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Zhuang Liu
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Lu Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Xiao-Jie Ju
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China.
| | - Liang-Yin Chu
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
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Molania T, Malekzadeh Shafaroudi A, Saeedi M, Moosazadeh M, Valipour F, Rostamkalaei SS, Salehabadi N, Salehi M. Evaluation of cinnamaldehyde mucoadhesive patches on minor recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled clinical trial. BMC Oral Health 2022; 22:235. [PMID: 35701773 PMCID: PMC9199160 DOI: 10.1186/s12903-022-02248-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background & objective The use of herbal medicines to treat common oral diseases increases rapidly. Recurrent aphthous stomatitis is one of the most common oral mucosal diseases, which has an unclear etiology and could lead to severe pain and dysfunction. Cinnamaldehyde is a major component of cinnamon bark oil. Biological properties of cinnamaldehyde, such as antioxidant, antitumor, antifungal, cytotoxic, and anti-mutational characteristics, have been identified. Considering the prevalence of recurrent aphthous stomatitis and the importance of using herbal resources for treatment, the present study aimed to evaluate the effect of mucosal adhesive patches containing Cinnamaldehyde on minor recurrent aphthous stomatitis lesions.
Material & methods In this randomized, double-blind clinical trial, patients were divided into two groups. The intervention group received three daily mucosal adhesive patches to be used in the morning, afternoon, and night. The control group also did the same with a placebo. To evaluate the healing and determine the diameter of the lesions, patients were clinically examined on days zero, 3, 5, and 7. The VAS scale evaluated pain at baseline and after each meal for seven days. The Fisher's exact test, t-test, Shapiro Wilk test, Friedman test, and the Mann–Whitney test were used to analyze the data using the SPSS 20 software.
Results There was no statistically significant difference in the mean diameter of the inflammatory lesion and pain intensity in the two groups in the baseline (p > 0.05). However, the ulcer size was significantly reduced in the cinnamaldehyde group on the third, fifth, and seventh days of the study. Except for baseline, the mean pain intensity significantly decreased in the cinnamaldehyde group compared to the placebo group (p < 0.05). Conclusion Cinnamaldehyde mucoadhesive patches effectively reduced and improved aphthous lesions and pain intensity in patients and can be considered a treatment for RAS. Registration number: IRCT20180312039060N2—First registration date: 20/07/2018. The present study was registered as a retrospective study.
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Affiliation(s)
- Tahere Molania
- Department of Oral Medicine, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran.,Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Malekzadeh Shafaroudi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Saeedi
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastroinstitional Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Seyyed Sohrab Rostamkalaei
- Department of Pharmaceutics, Faculty of Pharmacy, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran.,Medicinal Plant Research Center, Faculty of Pharmacy, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran
| | - Negareh Salehabadi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maede Salehi
- Department of Oral Medicine, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran. .,Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
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Bakhshi M, Mahboubi A, Jaafari MR, Ebrahimi F, Tofangchiha M, Alizadeh A. COMPARATIVE EFFICACY OF 1% CURCUMIN NANOMICELLE GEL AND 2% CURCUMIN GEL FOR TREATMENT OF RECURRENT APHTHOUS STOMATITIS: A DOUBLE-BLIND RANDOMIZED CLINICAL TRIAL. J Evid Based Dent Pract 2022; 22:101708. [DOI: 10.1016/j.jebdp.2022.101708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 12/13/2021] [Accepted: 01/13/2022] [Indexed: 12/29/2022]
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Yousefi H, Gholami M, Zoughi M, Rezaei N, Chuppani A, Nikfar S, Amoli MM. Role of genetic polymorphisms in recurrent aphthous stomatitis: A systematic review and meta-analysis. Cytokine 2022; 153:155864. [DOI: 10.1016/j.cyto.2022.155864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/25/2021] [Accepted: 03/08/2022] [Indexed: 11/03/2022]
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Recurrent Aphthous Stomatitis – An Overview. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2021-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Recurrent aphthous ulcers are common painful mucosal conditions affecting the oral cavity. Despite their high prevalence and knowledge of many etiological factors, the exact mechanism of disease is still not fully understood. There are three different clinical forms of recurrent aphthous stomatitis and the therapy differs depending on it.
The aim of this article is to provide an overview of current knowledge about the possible causes and treatment of recurrent aphthous stomatitis. We discuss its pathogenesis which is currently the least explained in the literature. This review offers scientists and clinicians useful information about clinical presentation, diagnosis, predisposing aetiological factors and recent trends in the management of recurrent aphthous stomatitis.
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KURKU H, YAVUZ C. Evaluation of Total Oxidant Status, Antioxidant Status and Oxidative Stress Index in Patients with Recurrent Aphthous Stomatitis. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.30934/kusbed.1033896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Tanacan E, Dinçer Rota D, Oktem R, Erdogan FG. The Correlation of Systemic Immune Inflammation Index, Neutrophil to Lymphocyte Ratio, Derived Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio with Disease Severity in Recurrent Aphthous Stomatitis. J Cosmet Dermatol 2022; 21:4858-4863. [PMID: 35150041 DOI: 10.1111/jocd.14838] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/15/2022] [Accepted: 02/08/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND/AIM To evaluate the correlation of systemic Immune Inflammation Index (SII), neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) with disease severity in recurrent aphthous stomatitis (RAS). METHODS The present retrospective cohort study was performed on patients with RAS. Patients were divided into three groups: 1) Major (n=75), 2) Minor (n=123), and 3) Herpetiform aphthae (n=17). The study groups were compared in terms of demographic features, acute phase proteins, and complete blood cell count parameters. Moreover, correlation analyses were performed for the correlation of ulcer severity score (USS) with C-reactive protein (CRP), SII, erythrocyte sedimentation rate (ESR), ferritin, dNLR, NLR and PLR. RESULTS Significantly higher values were observed for USS, neutrophil count, ferritin, SII, NLR and dNLR (p<0.05 for all) in the major and herpetiform aphtae groups compared to the minor aphtae group. Positive, strong, significant correlations were observed between USS, SII and NLR (r=0.80 for SII, r=0.74 for NLR and p<0.001 for both). Positive, moderate, significant correlations were observed between USS, PLR, ESR and CRP (r=0.54 for PLR, r=0.39 for ESR, r=0.36 for CRP and p<0.001 for all). Positive, weak, significant correlations were observed between USS, dNLR and ferritin (r=0.13 and p=0.05 for ferritin, r=0.27 and p<0.001 for dNLR). CONCLUSION Higher values of SII, NLR, dNLR, and PLR were associated with disease severity in patients with RAS.
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Affiliation(s)
- Efsun Tanacan
- Department of Dermatology and Veneorology, Ufuk University Hospital, Ankara, Turkey
| | - Didem Dinçer Rota
- Department of Dermatology and Veneorology, Ufuk University Hospital, Ankara, Turkey
| | - Rumeysa Oktem
- Department of Dermatology and Veneorology, Ufuk University Hospital, Ankara, Turkey
| | - F Gulru Erdogan
- Department of Dermatology and Veneorology, Ufuk University Hospital, Ankara, Turkey
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Kale I, Mhapuskar A, Thakare S, Karmarkar P, Hiremutt DP, Jadhav A. Comparison of effects of honey and 0.1% triamcinolone acetonide in the management of recurrent aphthous stomatitis - A randomised, single-blind study. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2022. [DOI: 10.4103/jiaomr.jiaomr_157_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Srivastava N, Aslam S. Recent Advancements and Patents on Buccal Drug Delivery Systems: A Comprehensive Review. RECENT PATENTS ON NANOTECHNOLOGY 2022; 16:308-325. [PMID: 34126916 DOI: 10.2174/1872210515666210609145144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 02/14/2021] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
The major requirement for a dosage form to be successful is its ability to penetrate the site of application and the bioavailability of the drug released from the dosage form. The buccal drug delivery is an influential route to deliver the drug into the body. Here, in this context, various novel approaches that include lipoidal carriers like ethosomes, transferosomes, niosomes etc. and electrospun nanofibers are discussed, with respect to buccal drug delivery. These carriers can be easily incorporated into buccal dosage forms like patches and gels that are responsible for increased permeation across the buccal epithelium. The in vivo methods of evaluation on animal models are conscribed here. The novel biocarriers of lipoidal and non-lipoidal nature can be utilized by loading the drug into them, which are helpful in preventing drug degradation and other drawbacks as compared to conventional formulations. The globally patented buccal formulations give us a wide context in literature about the patents filed and granted in the recent years. When it comes to patient compliance, age is an issue, which is also solved by the buccal route. The pediatric buccal formulations are researched for the customization to be delivered to children. Diseases like mouth ulcers, oral cancer, Parkinson's disease, aphthous stomatitis etc. have been successfully treated through the buccal route, which infers that the buccal drug delivery system is an effective and emerging area for formulation and development in the field of pharmaceutics.
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Affiliation(s)
- Nimisha Srivastava
- Department of Pharmaceutics, Faculty of Pharmacy, Amity University Uttar Pradesh, Lucknow, India
| | - Sahifa Aslam
- Department of Pharmaceutics, Faculty of Pharmacy, Amity University Uttar Pradesh, Lucknow, India
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Ghanadian S, Soltani R, Saberi Z, Taheri A, Entezarhojjat A. The effectiveness of olibanum orally disintegrating tablet in the treatment of oral aphthous ulcers: A randomized, double-blind, placebo-controlled clinical trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:8. [PMID: 35342437 PMCID: PMC8943586 DOI: 10.4103/jrms.jrms_247_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/13/2021] [Accepted: 07/26/2021] [Indexed: 11/15/2022]
Abstract
Background: Boswellia serrata oleo-gum-resin (frankincense; olibanum) has anti-inflammatory, analgesic, and antimicrobial effects. This study aimed to evaluate the clinical effectiveness of frankincense extract in the treatment of oral aphthous ulcers. Materials and Methods: In a randomized, double-blind, placebo-controlled clinical trial, patients with aphthous ulcers were randomly assigned to either experimental (Frankincense extract) or placebo groups to use orally disintegrating tablets (ODT) of frankincense and placebo, respectively, four times a day for 3 days. The size of aphthous ulcers and the pain severity by visual analogue scale were recorded at days 0, 2, and 4 and compared between the groups. Results: Twenty-five patients in each group completed the study. Olibanum extract ODT significantly reduced the ulcer size on the second (P < 0.001) and fourth (P < 0.001) days as well as the pain score on the second (P = 0.002) and fourth (P < 0.001) days of the intervention compared to placebo. Furthermore, at the end of the intervention, the number of patients with complete ulcer healing and pain relief in the experimental group was significantly more than the placebo group (5 vs. 0, P = 0.02; and 11 vs. 0, P < 0.001, respectively). Conclusion: Taking olibanum extract ODTs reduces the ulcer size and pain severity and accelerates the healing process in the oral aphthous lesions.
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Han Y, Wang L, Li Q, Chen H, Ma X. LncRNA NEAT1 is upregulated in recurrent aphthous stomatitis (RAS) and has predictive values. BMC Oral Health 2021; 21:673. [PMID: 34972503 PMCID: PMC8720213 DOI: 10.1186/s12903-021-01909-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022] Open
Abstract
Background LncRNA NEAT1 promotes inflammatory responses, which contribute to recurrent aphthous stomatitis (RAS). This study focused on the involvement of NEAT1 in RAS. Methods RT-qPCR and ELISA were performed to determine the expression of NEAT1 and proinflammatory factors (IL-2, IL-1β, and TNF-α) in plasma from patients with a history of RAS and showing symptom (n = 80, S-RAS group), people with a history of RAS but showing no symptom (n = 80, NS-RAS group), and controls without a history of RAS (n = 80, Control group). Correlation analysis was performed with Pearson’s correlation coefficient. S-RAS group received treatmen,t and plasma levels of NEAT1 and proinflammatory factors were compared before and after treatment. S-RAS group was followed up for 12 months, and the recurrence was recorded. Results Plasma NEAT1, IL-2, IL-1β, and TNF-α levels were the highest in the S-RAS group, followed in turn by NS-RAS and control groups. NEAT1 was positively and significantly correlated with IL-2, IL-1β, and TNF-α across S-RAS and NS-RAS samples, but not control samples. After treatment, plasma levels of NEAT1, IL-2, IL-1β, and TNF-α decreased significantly. Moreover, a higher recurrence rate was observed during the follow-up in patients with high plasma NEAT1 levels. Conclusion NEAT1 is upregulated in RAS and correlated with multiple proinflammatory factors. Moreover, NEAT1 has predictive values for RAS.
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Affiliation(s)
- Yaolun Han
- Department of Stomatology, Henan Provincial People's Hospital, No. 7 Weiwu RoadHenan Province, Zhengzhou City, 450000, People's Republic of China
| | - Lu Wang
- Department of Stomatology, Henan Provincial People's Hospital, No. 7 Weiwu RoadHenan Province, Zhengzhou City, 450000, People's Republic of China
| | - Qingfu Li
- Department of Stomatology, Henan Provincial People's Hospital, No. 7 Weiwu RoadHenan Province, Zhengzhou City, 450000, People's Republic of China
| | - Hongli Chen
- Department of Stomatology, Henan Provincial People's Hospital, No. 7 Weiwu RoadHenan Province, Zhengzhou City, 450000, People's Republic of China
| | - Xin Ma
- Department of Stomatology, Henan Provincial People's Hospital, No. 7 Weiwu RoadHenan Province, Zhengzhou City, 450000, People's Republic of China.
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Shabana SJS, Mutawakkil MHZ, El–Ashmaoui HMA, Zahran FMAQ. Interleukin-6 gene polymorphism in Saudi population with recurrent aphthous stomatitis. Saudi Dent J 2021; 33:972-978. [PMID: 34938040 PMCID: PMC8665156 DOI: 10.1016/j.sdentj.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 06/23/2021] [Accepted: 07/04/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Recurrent aphthous ulcers are common but poorly understood mucosal disorder. Local and systemic conditions, genetic, immunological, and microbial factors may play a role in the pathogenesis of recurrent aphthous ulceration (RAS). Different aetiologies and mechanisms might be involved in the aetiopathogenesis of aphthous ulceration. Cytokines are thought to play an important role and high levels of interleukin (IL)-6, a pro-inflammatory cytokine, have been detected in the circulation of ulcer tissue. The purpose of the present study was to investigate if polymorphisms of IL-6 gene are associated with RAS in a cohort of specific population. Methodology A total of 37 RAS patients and 18 healthy controls were included in the study. The genotypes of IL-6 gene -174G\C polymorphisms were determined using polymerase chain reaction and sequencing. Results Four SNPs were analyzed, one known mutation which been evaluated as a risk factor for RAS, and three new mutations were investigated. The genotype frequencies of -174G\C polymorphism showed no statistically significant differences between RAS patients and controls (p\ 0.629). Polymorphisms of Rs1800795 heterozygous genotype were found in 21.62% of cases, and 33.33% of controls. Homozygous mutant genotype was found in 5.41% of cases and no homozygous mutant genotype was found in control group. The normal alleles were found in 72.97% of cases and 66.67% of control. Conclusion Thus, according to our study, IL-6 gene polymorphism is not involved in RAS pathogenesis. Further studies should be done on large sample size to detect any association with pathogenesis. However, an alternative reasoning could point out to a complex interactive effect on IL-6 expression that might exist between any of the detected polymorphisms.
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Affiliation(s)
| | - Muhammad Hamid Zaini Mutawakkil
- Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- Corresponding author at: Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.
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Hosseinpour-Moghadam R, Mehryab F, Torshabi M, Haeri A. Applications of Novel and Nanostructured Drug Delivery Systems for the Treatment of Oral Cavity Diseases. Clin Ther 2021; 43:e377-e402. [PMID: 34844769 DOI: 10.1016/j.clinthera.2021.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Novel drug delivery systems (DDSs) hold great promise for the treatment of oral cavity diseases. The main objective of this article was to provide a detailed overview regarding recent advances in the use of novel and nanostructured DDSs in alleviating and treating unpleasant conditions of the oral cavity. Strategies to maximize the benefits of these systems in the treatment of oral conditions and future directions to overcome these issues are also discussed. METHODS Publications from the last 10 years investigating novel and nanostructured DDSs for pathologic oral conditions were browsed in a systematic search using the PubMed/MEDLINE, Web of Science, and Scopus databases. Research on applications of novel DDSs for periodontitis, oral carcinomas, oral candidiasis, xerostomia, lichen planus, aphthous stomatitis, and oral mucositis is summarized. A narrative exploratory review of the most recent literature was undertaken. FINDINGS Conventional systemic administration of therapeutic agents could exhibit high clearance of drugs from the bloodstream and low accumulation at the target site. In contrast, conventional topical systems face problems such as short residence time in the affected region and low patient compliance. Novel and nanostructured DDSs are among the most effective and commonly used methods for overcoming the problems of conventional DDSs. The main advantages of these systems are that they possess the ability to protect active agents from systemic and local clearance, enhance bioavailability and cellular uptake, and provide immediate or modified release of therapeutic agents after administration. In the design of local drug delivery devices such as nanofiber mats, films, and patches, components and excipients can significantly affect factors such as drug release rate, residence time in the oral cavity, and taste in the mouth. Choosing appropriate additives is therefore essential. IMPLICATIONS Local drug delivery devices such as nanofiber mats, nanoparticles, liposomes, hydrogels, films, and patches for oral conditions can significantly affect drug efficacy and safety. However, more precise clinical studies should be designed and conducted to confirm promising in vitro and in vivo results. In recent years, novel and nanostructured DDSs increasingly attracted the attention of researchers as a means of treatment and alleviation of oral diseases and unpleasant conditions. However, more clinical studies should be performed to confirm promising in vitro and in vivo results. To transform a successful laboratory model into a marketable product, the long-term stability of prepared formulations is essential. Also, proper scale-up methods with optimum preparation costs should be addressed.
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Affiliation(s)
- Reza Hosseinpour-Moghadam
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mehryab
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Torshabi
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Haeri
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Protein Technology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Srivastava A, Gc S, Pathak S, Ingle E, Kumari A, Shivakumar S, Pg NK, Singh AK. Evidence-based effectiveness of herbal treatment modality for recurrent aphthous ulcers - A systematic review and meta-analysis. Natl J Maxillofac Surg 2021; 12:303-310. [PMID: 35153423 PMCID: PMC8820316 DOI: 10.4103/njms.njms_249_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/16/2020] [Accepted: 01/28/2021] [Indexed: 11/07/2022] Open
Abstract
Recurrent Apthous Ulcers (RAU) has affected mankind through time immemorial. It is the most commonly prevalent oral mucosal lesion manifesting as painful ulcers involving non – keratinised oral mucosa. This review was done to assess herbal intervention in RAU patients for outcomes of ulcer size and pain intensity. Literature search of published articles in Medline, Scopus, Ovid and Journal of Web upto August 2020 were reviewed for the pre-described outcomes. Revman 5.4 software was used for study analysis. Total 9 articles were finally chosen for qualitative analysis. Meta analytic comparison demonstrated the ulcer reduction (CI = -2.22 to – 0.09; p <0.001) and pain intensity (CI = -4.60 to – 0.08; p <0.001) was reduced in the herbal group as compared to the controls. A definite evidence of herbal intervention was noted in alleviating RAU signs and symptoms.
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Affiliation(s)
- Adit Srivastava
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - ShivaKumar Gc
- Department of Oral Medicine and Radiology, Peoples College of Dental Sciences, Bhanpur, Bhopal, Madhya Pradesh, India
| | - Swarnasmita Pathak
- Department of Oral Medicine and Radiology, Regional Dental College, Guwahati, Assam, India
| | - Ekta Ingle
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Anjali Kumari
- Department of Oral Medicine and Radiology, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Sahana Shivakumar
- Department of Public Health Dentistry, Peoples College of Dental Sciences, Bhanpur, Bhopal, Madhya Pradesh, India
| | - Navin Kumar Pg
- Department of Public Health Dentistry, Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Akhilesh Kumar Singh
- Department of Oral and Maxillofacial Surgery, IMS, BHU, Varanasi, Uttar Pradesh, India
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Combination of Levamisole with Prednisone in Treating Recurrent Major Aphthous Ulcer in a Young Boy: A Case Report. Clin Pract 2021; 11:250-256. [PMID: 34066438 PMCID: PMC8161451 DOI: 10.3390/clinpract11020038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/02/2021] [Accepted: 04/29/2021] [Indexed: 12/05/2022] Open
Abstract
Recurrent aphthous stomatitis (RAS) is an oral condition characterized by painful oral ulcerations. While the clinical features of this disease are easily defined, the etiology remains unclear. Thus, existing treatments are still unsatisfactory in reducing the severity, healing, and recurrence rate; however, there is no permanent and definitive treatment. Effective treatment for aphthous stomatitis is not available, and those treatments available mainly focus on suppressing its symptoms. We are reporting a case of a 17-year-old boy who presented with a 3-year history of multiple recurrent major ulcers in the oral cavity. Levamisole with steroids has been used in many clinical trials to treat aphthous ulcers, showing an improvement in pain, discomfort, healing time, and reduction in the number of ulcers. The same method was used to treat our patient, who showed promising results, with no recurrence for one year. Levamisole is a safe, easily tolerable and promising drug for the treatment of RAS.
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Kwon KJ, Jeong SJ, Eun YG, Oh IH, Lee YC. Risk of cancer in patients with recurrent aphthous stomatitis in Korea: A nationwide population-based study. Medicine (Baltimore) 2021; 100:e25628. [PMID: 33879738 PMCID: PMC8078402 DOI: 10.1097/md.0000000000025628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 04/01/2021] [Indexed: 01/04/2023] Open
Abstract
The relationship between recurrent aphthous stomatitis (RAS), a common mucosal lesion, and cancer has not been demonstrated. This study investigated the risk for developing cancer in patients with RAS, based on data from Korea's National Health Insurance Sharing Service (NHISS). Nationwide population-based cohort data from 2005 to 2009 provided by the NHISS was used. The group diagnosed with RAS for 5 years and an undiagnosed control group were constructed through 1:1 propensity score matching (PSM). The experimental design compared the incidence rate of a cancer diagnosis from 2010 to 2015 between these 2 groups. After identifying 13,808 people that met our inclusion criterion from a 1 million cohort group, 13,808 controls were included in the study through PSM. Among all cancers, pancreatic cancer had an adjusted hazard ratio of 1.26 (95% confidence interval: 1.01-1.57, P < .041). For the rest of the cancers, there was no significant incidence rate. RAS was associated with an increased risk of pancreatic cancer in the analysis using large population-based cohort data. Further long-term follow-up studies are needed.
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Affiliation(s)
- Ki Jin Kwon
- Department of Otolaryngology – Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul
| | - Su Jin Jeong
- Kyung Hee University Hospital, Medical Science Research Institute
| | - Young-Gyu Eun
- Department of Otolaryngology – Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul
| | - In Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young Chan Lee
- Department of Otolaryngology – Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul
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Zhu Z, He Z, Xie G, Fan Y, Shao T. Altered oral microbiota composition associated with recurrent aphthous stomatitis in young females. Medicine (Baltimore) 2021; 100:e24742. [PMID: 33725829 PMCID: PMC7969233 DOI: 10.1097/md.0000000000024742] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 01/22/2021] [Indexed: 01/05/2023] Open
Abstract
Oral microbiota has been implicated in pathogenesis of recurrent aphthous stomatitis (RAS), which is a common mucosal disorder with unclear etiology. This study has explored the association between oral microbiota disorder and RAS in high-risk young female population.Forty-five young females were enrolled, including 24 RAS patients and 21 healthy individuals. Oral microbiome was analyzed by Illumina Miseq sequencing.Oral microbiota associated with RAS was characterized by the lower alpha-diversity indices (Chao1 and ACE). Several infectious pathogens increased in RAS, such as genera Actinobacillus, Haemophilus, Prevotella and Vibrio. The PICRUSt analysis indicated that the oral microbiota might be related with the up-regulation of genes involving infectious and neurodegenerative diseases, environmental adaptation, the down-regulation of genes involving basal metabolism, such as carbohydrate, energy, and amino acid metabolism.This study indicated that oral microbiota may play a significant role in RAS development.
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Affiliation(s)
- Zhengyang Zhu
- The first clinical college, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Zhixing He
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Guanqun Xie
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Yongsheng Fan
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Tiejuan Shao
- Institute of Basic Research in Clinical Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
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Wahyuni IS, Sufiawati I, Nittayananta W, Puspitasari IM, Levita J. Efficacy and safety of plant-based therapy on recurrent aphthous stomatitis and oral mucositis in the past decade: a systematic review. JOURNAL OF HERBMED PHARMACOLOGY 2021. [DOI: 10.34172/jhp.2021.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Oral mucosal inflammation is one of the oral diseases causing pain and reducing the quality of human life. The types of oral mucosal inflammation that commonly found were recurrent aphthous stomatitis (RAS) and oral mucositis (OM). Anti-inflammatory drugs, both synthetic and plant-based, have been used to treat RAS and OM. Plant-based drugs have been attracted the attention of some researchers to minimize the side effects of synthetic drugs. However, a comprehensive review addressing the use of plant-based drugs for RAS and OM therapy, including drug formulation and species of plant, has not yet been reported. Here, we reported the article review of 9 publications derived from the databases of PubMed, ScienceDirect, Cochrane Library, and other additional relevant works, in order to find the effectiveness and safety of plant-based drugs for RAS and OM therapy. This review was written by following the PRISMA guidelines, and the risk of bias of the articles was evaluated using the Oxford Quality Scoring System. It was found that the effective and safe drugs for RAS therapy contained acemannan from Aloe vera and curcumin from Curcuma longa, both in an oral gel formulation. For OM therapy, drugs contained curcumin from Curcuma longa; licorice from Glycyrrhiza glabra; Aloe vera and black mulberry from Morus nigra, in soft tablet, mouthwash solution or mucoadhesive film formulation. In conclusion, the most effective and safest plant-based therapy for RAS is Acemannan 0.5% in oral gel, whereas for OM is Licorice root extract 0.18 mg in mucoadhesive film.
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Affiliation(s)
- Indah Suasani Wahyuni
- Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
- Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia
| | - Irna Sufiawati
- Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | | | - Irma Melyani Puspitasari
- Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia
| | - Jutti Levita
- Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia
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Gharibpour F, Fakheran O, Parvaneh A, Shirban F, Bagherniya M, Sathyapalan T, Sahebkar A. The Clinical Use of Curcumin for the Treatment of Recurrent Aphthous Stomatitis: A Systematic Review of Clinical Trials. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1291:229-238. [PMID: 34331693 DOI: 10.1007/978-3-030-56153-6_13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Recurrent aphthous stomatitis (RAS) lesions are inflammatory painful oral ulcers with uncertain etiology. Curcumin acts as an effective anti-inflammatory and antibacterial agent in the treatment of various oral diseases. This systematic review aimed to assess the effects of curcumin on RAS. A systematic search of the medical databases, PubMed, Scopus, ISI, Science Direct, and Google Scholar was performed up to March 30, 2020, to identify clinical trials assessing the effect of curcumin on aphthous ulcers. Nine studies comprising of 469 participants met all criteria and were analyzed. Treatment with curcumin significantly reduced aphthous ulcer size (seven studies), pain intensity (eight studies), number of aphthous ulcers (three studies), erythematous halo (one study), and erythema and exudate of the aphthous (one study). In four studies, the effect of curcumin on aphthous ulcer was assessed in comparison to the effects of the standard medication, triamcinolone. In all of these studies, curcumin had similar beneficial effects on the aphthous ulcer as measured by ulcer size, number, and pain. Only three studies were categorized as high quality using the Jadad scale. Within the limitations of this review, it can be concluded that curcumin may have a beneficial role in the treatment of recurrent aphthous ulcers. However, more randomized clinical trials are needed to validate these findings.
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Affiliation(s)
- Fateme Gharibpour
- Department of Orthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Fakheran
- Dental Research Center, Department of Periodontics, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Parvaneh
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farinaz Shirban
- Department of Orthodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Bagherniya
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Thozhukat Sathyapalan
- Department of Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. .,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Poland. .,Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland. .,Halal Research Center of IRI, FDA, Tehran, Iran.
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Khaleel Ahmed M, Jafer M, Nayeem M, Hussain Moafa I, Quadri MFA, Gopalaiah H, Ali Quadri MF. Low-Level Laser Therapy and Topical Medications for Treating Aphthous Ulcers: A Systematic Review. J Multidiscip Healthc 2020; 13:1595-1605. [PMID: 33239881 PMCID: PMC7680689 DOI: 10.2147/jmdh.s281495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/06/2020] [Indexed: 12/31/2022] Open
Abstract
Objective The study compares low-level laser therapy with topical medications for treating aphthous ulcers. Methods A search of articles in this systematic review was completed in six databases. Treatment and comparative groups comprised of patients subjected to laser therapy and topical medications, respectively. Two different treatment outcomes were considered; pain and size of the lesion. Risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials. Results From 109 articles, five randomized control trials fulfilled the selection criteria. The overall sample comprised of 98 males and 232 females, with a mean age of 32.4 years. The laser therapies in each included study had different active media and varying wavelengths. Topical medication used in the comparative group were triamcinolone acetonide, amlexanox, granofurin, and solcoseryl. Findings showed that patients who reported lower pain and decreased aphthous ulcer lesions were more in the laser therapy group than in the topical medication group. Conclusion Low-level laser therapy was better in treating aphthous ulcer lesions in comparison to topical medications, and all laser wavelengths in the included reports were seen to be effective. However, the results should be interpreted with caution, because no study demonstrated low-risk of bias in all the assessed domains.
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Affiliation(s)
| | - Mohammed Jafer
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
| | - Maryam Nayeem
- Department of Pharmacology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Ibtisam Hussain Moafa
- Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Mir Furruq Ali Quadri
- Department of Internal Medicine, Lister Hospital, East and North Hertfordshire, NHS Trust, Stevenage, UK
| | - Hema Gopalaiah
- Department of Oral Medicine and Radiology, M.N.R Dental College, India
| | - Mir Faeq Ali Quadri
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
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Clinical characteristics and risk factors of major oral ulcers in the mandibular retromolar region in children. Clin Oral Investig 2020; 25:3505-3512. [PMID: 33145696 DOI: 10.1007/s00784-020-03672-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To describe the characteristics of major aphthous ulcers (MjOU) in children and analyze its potential risk factors. MATERIALS AND METHODS Data were collected from the National Clinical Research Center for Oral Diseases of China between 2012 and 2017. Children younger than 15 years old, who had a giant mucosa ulcer (≥ 1 cm in diameter) and met the diagnostic criteria for MjOU were included in this study. Differences were compared between two subgroups of patients based on the location of the ulcerous lesions. A measurement of ratio (TBR) between the length of the mandibular second molar tooth germ and the height of the mandible was performed in children with MjOU lesions located in the mandibular retromolar pad region (MjOU-P) and their age- and sex-matched controls. RESULTS A total of 1067 children were diagnosed with oral ulcers during the study period, of which 125 (11.7%, 95% CI: 9.8%-13.7%) met the diagnostic criteria for MjOU. More than half (n = 64, 51.2%) of the MjOU cases were MjOU-P, which had a male predilection (n = 52, 81.3%) with a significant majority at 7 to 9 years of age (n = 43, 67.2%). In comparison to the MjOU located in other regions, MjOU-P lasted longer in duration and had more comorbidities. Logistic regression analysis showed that MjOU-P was statistically significantly associated with TBR controlling age and gender. CONCLUSIONS MjOU-P is a predominant form of MjOU in children and is a distinct subgroup of major ulcers that is likely associated with the development of the mandibular second molars. CLINICAL RELEVANCE This study is the first to describe the demographic and clinical features of MjOU in children, which may facilitate the identification and treatment of these patients.
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Effect of different treatments on recurrent aphthous stomatitis: laser versus medication. Lasers Med Sci 2020; 36:1095-1100. [PMID: 33140267 DOI: 10.1007/s10103-020-03166-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 10/21/2020] [Indexed: 12/15/2022]
Abstract
Recurrent aphthous stomatitis (RAS) is a common disease with ulcers in oral cavity which may trigger chewing, speaking, and swallowing difficulties to patients. Treatment of RAS is primarily aimed at pain relief and the promotion of wound healing. However, few agents have been found to have definite effect in the management of RAS and most of the medicinal products may cause adverse reactions or other disadvantages, which makes their clinical usage questionable. The purpose of this randomized controlled clinical trial (RCT) was to assess the clinical effect of diode laser and traditional medication treatment on RAS. In this study, 56 patients were randomly assigned to two groups (n = 28). Laser group was treated using diode laser (810 nm, 1.0 W, CW, irradiation time 20 s for 3 applications) once daily for continuous 3 days. Medication group was treated with triamcinolone acetonide 0.1% three times a day until the lesion was healed. Spontaneous and functional pain level on the third day of treatment was significantly less in the laser group. Significant difference was observed with respect to healing time; however, the order of difference is small albeit of statistical significance. Diode laser with the chosen parameters had better effects on pain relief and no distinct advantage on wound healing comparing with medication. Trial registration number: ChiCTR2000030298; date of registration: 26 February 2020 (retrospectively registered).
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Coletta RD. Fill the gap, get the answer: Comments on “A family‐based genome‐wide association study of RAS”. Oral Dis 2020; 26:1830-1831. [DOI: 10.1111/odi.13553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/08/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Ricardo D. Coletta
- Department of Oral Diagnosis Piracicaba Dental School University of Campinas Piracicaba Brazil
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Abstract
Inflammatory bowel disease (IBD) is a chronic relapsing remitting autoimmune disease including Crohn's disease and ulcerative colitis. IBD is associated with various extra-intestinal manifestations including oral manifestation. To date, only limited studies addressing the characteristics of the oral manifestations are available. The aim of the present review is to report the oral manifestations and their characteristics in IBD. A Medline/PubMed and Embase databases search were conducted and all relevant studies were extracted and analyzed. Overall, the oral manifestations in IBD were mostly associated with Crohn's disease rather than Ulcerative colitis where their prevalence ranged from 8 to 50%. Specific lesions for Crohn's disease include mucosal tags, cobblestoning and deep linear ulcerations with vertical fissures, while for ulcerative colitis, pyostomatisis vegetans was more disease specific. Notably, most of the oral manifestations were unrelated to disease activity, however more data are needed to accurately assess this correlation. Oral manifestations among IBD patients are not uncommon as Crohn's disease account for most of them. More data are warranted to precisely characterize their prevalence and association to intestinal activity.
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Kia SJ, Mansourian A, Basirat M, Akhavan M, Mohtasham-Amiri Z, Moosavi MS. New concentration of curcumin orabase in recurrent aphthous stomatitis: A randomized, controlled clinical trial. J Herb Med 2020. [DOI: 10.1016/j.hermed.2020.100336] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Ghorbani A, Akbari J, Boorboor M, Nekoukar Z, Eslami G. Evaluation of zinc sulfate mucoadhesive formulation on recurrent aphthous stomatitis: a randomized double-blind, placebo-controlled clinical trial. BMC Oral Health 2020; 20:212. [PMID: 32723352 PMCID: PMC7385976 DOI: 10.1186/s12903-020-01194-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS) is a common lesion that affects the oral mucosa. There are several methods to treat RAS, including systemic and topical formulations. This study was conducted to evaluate the anti-inflammatory effect of topical zinc sulfate and its efficacy in the treatment of RAS. METHODS A double-blind randomized clinical trial was conducted on 46 patients with RAS. They were randomly assigned into two groups to receive a zinc sulfate mucoadhesive tablet or placebo for 7 days. The pain severity was measured at baseline and daily while the diameter of the lesion was measured at baseline and on days 3, 5, and 7. The obtained data were analyzed in SPSS V.16. RESULTS There was no significant difference in the mean diameter of lesions and pain at baseline between the two groups (P = 0.643 and P = 0.842, respectively). However, on the third, fifth, and seventh days of the study, the diameter of the lesion significantly reduced in the intervention group (P = 0.001) and the pain intensity became significantly different between groups from the fourth day of the study (P = 0.001). CONCLUSION Zinc sulfate mucoadhesive tablet was effective in recovery and reducing the pain and diameter of the aphthous lesion and could be considered for the treatment of RAS. TRIAL REGISTRATION Evaluation of the effectiveness of zinc sulfate mucoadhesive tablet in the improvement of recurrent aphthous stomatitis (RAS), IRCT20151109024975N9. Registered August 1, 2018, https://en.irct.ir/trial/32423 . This project was registered by the Iranian Registry of Clinical Trials ( http://www.irct.ir ). The IRCT ID was IRCT20151109024975N9.
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Affiliation(s)
- Anahita Ghorbani
- Department of Oral and Maxillofacial Diseases, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jafar Akbari
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Boorboor
- Department of Oral and Maxillofacial Diseases, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Nekoukar
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Gohar Eslami
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
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Singh H, Nambiar N, Samani D, Gangakhedkar RR. Occurrence of Interleukin-2 (330 G/T) Promoter Polymorphism in ARV associated hepatotoxicity. Curr Mol Med 2020; 19:206-215. [PMID: 30973108 DOI: 10.2174/1566524019666190411093451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 04/10/2019] [Accepted: 04/10/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND IL-2 cytokine is involved in HIV replication and is also known to cause hepatic injury. Polymorphisms in the IL-2 gene are associated with altered interleukin-2 production. METHODS Hence, we assessed the prevalence of IL-2-303G/T polymorphism in 165 HIV patients (34 with and 131without hepatotoxicity) and 155 healthy controls using the PCR-RFLP method. RESULTS In patients with hepatotoxicity, IL-2-303GT, -303GT+TT genotypes were less prevalent as compared to without hepatotoxicity and healthy controls (29.4% vs. 42.7%, 58.8% vs. 69.5%; 29.4% vs. 40.6%, 58.8% vs. 66.5%, respectively). In patients with hepatotoxicity using tobacco and alcohol, IL-2-303GT,-303TT genotypes were distributed higher as compared to non-users (42.9% vs. 25.9%, OR=8.52, 42.9% vs. 25.9%, OR=9.09, and 28.6% vs. 29.6%, OR=1.63, 42.9% vs. 25.9%, OR=2.93), while IL-2-303TT genotype occurred more often in HIV patients consuming alcohol (34.1% vs. 23.0%). Nevirapine users with hepatotoxicity overrepresented the IL-2-303GT,-303TT genotypes as compared to efavirenz (34.8% vs. 18.2%, OR=4.64, 34.8% vs. 18.2%, OR=3.88). Among nevirapine users, IL-2-303GT genotype was associated with susceptibility to the acquisition of hepatotoxicity with borderline significance (OR=4.24, P=0.06). HIV patients using nevirapine majorly represented the IL-2-303TT genotype (26.9% vs. 25.0%, OR=2.35) while HIV patients with nevirapine + alcohol usage presented the IL-2 -330TT genotype at a higher frequency (34.2%% vs. 23.5%, OR=1.51). In patients with hepatotoxicity using nevirapine + alcohol, the genotype IL-2 - 330TT was predominant (60.0% vs. 27.8%, OR=3.16). CONCLUSION Thus, IL-2-303G/T polymorphism did not confer the susceptibility to ARV associated hepatotoxicity. However, IL-2-303G/T polymorphism with nevirapine usage may facilitate the risk for acquisition of ARV associated hepatotoxicity.
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Affiliation(s)
- HariOm Singh
- Department of Molecular Biology, National AIDS Research Institute Pune- 411026, India
| | - Nayana Nambiar
- Department of Molecular Biology, National AIDS Research Institute Pune- 411026, India
| | - Dharmesh Samani
- Department of Molecular Biology, National AIDS Research Institute Pune- 411026, India
| | - Raman R Gangakhedkar
- Department of Clinical Sciences, National AIDS Research Institute Pune- 411026, India
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Bardellini E, Veneri F, Amadori F, Conti G, Majorana A. Photobiomodulation therapy for the management of recurrent aphthous stomatitis in children: clinical effectiveness and parental satisfaction. Med Oral Patol Oral Cir Bucal 2020; 25:e549-e553. [PMID: 32388522 PMCID: PMC7338059 DOI: 10.4317/medoral.23573] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/10/2020] [Indexed: 01/26/2023] Open
Abstract
Background This study aims to evaluate the effectiveness of the photobiomodulation therapy (PBMT) in the treatment of minor recurrent aphthous stomatitis (MiRAS) in children, in terms of pain relief, lesion size reduction and the parental satisfaction of the therapy.
Material and Methods This randomized controlled study was carried out on 60 children with clinical diagnosis of MiRAS. Patients were randomized into two groups: group A receiving laser therapy and group B receiving sham therapy (placebo). Laser therapy (diode laser, λ: 645 nm) was administered on day 1 (T0) for three consecutive days. Patients were evaluated also on day 4 (T1), on day 7 (T2) and on day 10 (T3). Oral aphthous lesions size was assessed through a periodontal probe to measure the diameter length (mm); pain was evaluated through the Visual Analogue Scale (VAS); parental satisfaction was assessed through a questionnaire.
Results The difference in the reduction of ulcers diameters between the two groups resulted statistically significant at T1 and at T2 (p<0.05). A statistically significant difference in pain reduction between two groups was found at T1 (p<0.05). No statistically significant difference between the two groups of parents was found as concerns the parental acceptance of the procedure and the discomfort for the need of multiple appointments.
Conclusions PBMT is to be considered effective in the treatment of MiRAS in children and well- accepted by the parents of the children themselves. Key words:Ulcers, children, lasers
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Affiliation(s)
- E Bardellini
- Dental Clinic, p.le Spedali Civili n.1 25133 Brescia
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Yang Z, Li M, Xiao L, Yi Z, Zhao M, Ma S. Hyaluronic acid versus dexamethasone for the treatment of recurrent aphthous stomatitis in children: efficacy and safety analysis. Braz J Med Biol Res 2020; 53:e9886. [PMID: 32609262 PMCID: PMC7326376 DOI: 10.1590/1414-431x20209886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 05/16/2020] [Indexed: 01/07/2023] Open
Abstract
The objective of this study was to compare the safety and efficacy of 0.2% hyaluronic acid (HA) topical gel and dexamethasone topical ointment in the treatment of recurrent aphthous ulcers (RAU) in children. This retrospective observational study included 104 patients who had more than two episodes of oral aphthous ulcers per year and were treated with HA (n=52) or dexamethasone (n=52) from August 15, 2014 to September 3, 2018. Therapy efficacy was evaluated based on the ulcer size and pain score before versus 7 days after either therapy. The paired t-test, chi-squared test, and independent t-test were utilized for statistical analyses. There was no significant difference in ulcer size or pain score between the HA and dexamethasone groups, on day 1 or day 7. Both treatments were tolerated well and no side effects were reported. No significant differences in body temperature, respiration rate, pulse, or systolic/diastolic blood pressure were observed between the start (day 1) and end of treatment (day 7), for either treatment. HA and dexamethasone showed similar efficacy in reducing ulcer size and pain scores, and were tolerated equally well in children with RAU. Future high-quality studies with larger numbers of patients are needed to confirm our findings.
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Affiliation(s)
- Zheng Yang
- Department of Stomatology, Jiangmen Maternal and Child Health
Hospital (Jiangmen Children's Hospital), Jiangmen, Guangdong, China
| | - Miaojuan Li
- Prevention and Healthcare, Jiangmen Municipal Stomatological
Hospital, Jiangmen, Guangdong, China
| | - Lin Xiao
- Department of Stomatology, Jiangmen Maternal and Child Health
Hospital (Jiangmen Children's Hospital), Jiangmen, Guangdong, China
| | - Zhiming Yi
- Department of Stomatology, Jiangmen Pengjiang Pinjie Dental
Clinic, Jiangmen, Guangdong, China
| | - Min Zhao
- Department of Stomatology, Jiangmen Maternal and Child Health
Hospital (Jiangmen Children's Hospital), Jiangmen, Guangdong, China
| | - Shengjie Ma
- Department of Stomatology, Jiangmen Maternal and Child Health
Hospital (Jiangmen Children's Hospital), Jiangmen, Guangdong, China
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Yang Z, Cui Q, An R, Wang J, Song X, Shen Y, Wang M, Xu H. Comparison of microbiomes in ulcerative and normal mucosa of recurrent aphthous stomatitis (RAS)-affected patients. BMC Oral Health 2020; 20:128. [PMID: 32349736 PMCID: PMC7189554 DOI: 10.1186/s12903-020-01115-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/15/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS) is the most common form of oral ulcerative disease, whose cause is still unknown. Researchers have found the association of many factors with the occurrence of RAS, and proposed oral bacterial infection could be a cause for this disease. METHODS To investigate whether the occurrence of RAS is associated with oral bacterial infection, we performed high throughput sequencing analysis of bacterial samples collected from the normal oral mucosa and aphthous ulcers of 24 patients. RESULTS Firmicutes, Proteobacteria and Bacteriodetes were the most abundant phyla in the microbiomes analysed. The alpha diversities of the oral mucosa and aphthous ulcer microbiomes were similar, suggesting a similar richness and diversity. The NMDS analysis showed the oral mucosa and aphthous ulcer microbiomes are significantly different. This suggestion is further supported by Anosim, MRPP, and Adonis analyses. More detailed comparison of the two groups of microbiomes suggested that the occurrence of RAS is significantly associated with the increase of Escherichia coli and Alloprevotella, as well as the decrease of Streptococcus. CONCLUSIONS Considering E. coli is a very common intestinal bacterium, we propose that E. coli colonization could be a cause for RAS, and controlling E. coli colonization could help curing RAS.
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Affiliation(s)
- Zhongjun Yang
- State Key Laboratory of Microbial Technology, Qilu Hospital, Shandong University, Qingdao, Shandong, China
| | - Qingyu Cui
- State Key Laboratory of Microbial Technology, Qilu Hospital, Shandong University, Qingdao, Shandong, China
| | - Ran An
- College of Food Science and Pharmaceutical Engineering, Zaozhuang University, Zaozhuang, Shandong, China
| | - Juan Wang
- State Key Laboratory of Microbial Technology, Qilu Hospital, Shandong University, Qingdao, Shandong, China
| | - Xiaobo Song
- Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Yu Shen
- State Key Laboratory of Microbial Technology, Qilu Hospital, Shandong University, Qingdao, Shandong, China
| | - Mingyu Wang
- State Key Laboratory of Microbial Technology, Qilu Hospital, Shandong University, Qingdao, Shandong, China.
| | - Hai Xu
- State Key Laboratory of Microbial Technology, Qilu Hospital, Shandong University, Qingdao, Shandong, China.
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